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Birth control prescription from a druggist?

CONCORD — New Hampshire could become one of a handful of states that allows birth control pills to be prescribed by pharmacists, after a commission appointed by the state Legislature voted unanimously on Thursday to endorse the concept.

“The idea is to create a statewide protocol as a model, so pharmacists can use standing orders to dispense birth control pills to people who need them without going to see doctors first,” said Rep. William Marsh, R-Wolfeboro, a member of the commission.

The Commission to Study Allowing Pharmacists to Prescribe Oral Contraceptives was created earlier this year by the passage of HB 264, which was signed into law by Gov. Chris Sununu.

The commission has met seven times since September.

HB 1449, “an act making hormonal contraceptives available directly from pharmacists by means of a standing order,” has already been drafted for the 2018 session by Marsh, with other commission members as co-sponsors.

The 16-member commission had only four lawmakers — Reps. Mariellen MacKay, R-Nashua; Peter Schmidt, D-Dover; Sen. Donna Soucy, D-Manchester; and Marsh. The other seats were occupied by representatives of various stakeholder groups, such as the state Pharmacists Association, Board of Pharmacy, Medical Society and Board of Nursing.

“The Medical Society was represented, the pharmacy groups, it came together very nicely,” said Marsh. “It was a bipartisan effort, and we need more bipartisan efforts.”

Concept expanding

Pharmacists in California, Oregon and Washington state are able to prescribe contraceptives, and are paid for the evaluation they have to conduct in addition to the drugs.

At least 11 other states and the District of Columbia are considering similar legislation. Numerous professional groups, including the American College of Obstetricians and Gynecologists and the American Academy of Family Physicians, have endorsed the concept.

“They believe it would be desirable to expand birth control by making birth control pills available without a prescription for the public health goal of preventing unintended pregnancy,” according to the commission report. “Until and unless the Food and Drug Administration permits birth control pills to be sold without a prescription, this is impossible.”

So states are working on protocols that would enable a standing order for pharmacists to prescribe. The Department of Health and Human Services, along with the boards of nursing, medicine and pharmacy, would collaborate with other stakeholders to draft the language.

“The term statewide protocol refers to a framework that specifies the conditions under which pharmacists are authorized to prescribe a specific medication or category of medications,” according to the National Alliance of Pharmacy Associations.

Such protocols usually include the training or qualifications required for licensed pharmacists to implement the program, procedures for implementation, the criteria that patients would have to meet, requirements for documentation and maintenance of records, and communication requirements, such as notification to the primary care provider.

Plan endorsed

The commission report describes hormonal contraceptives as pills, patches and rings approved by the FDA for contraception or emergency contraception.

It would not include items such as intrauterine devices, shots or under-the-skin implants.

MacKay declined comment at this time.

“The commission did an excellent job,” she said. “It was a roll call vote, 16-0. That was an excellent vote, but until we’re through our legislative process, I would rather not make any concrete comment.”

The commission also endorsed a plan by Sen. Soucy to submit legislation requiring that public and private insurance plans cover a 12-month supply of prescribed, self-administered hormonal contraception, which the patient can acquire in a single pharmacy visit.